The Diagnostic and Statistical Manual of Mental Disorder

Most individuals are likely unfamiliar with The Diagnostic and Statistical Manual of Mental Disorder, or the DSM-IV (the IV because it is in its fourth revision). I can’t blame you. Unfortunately mental disorders are still stigmatized and hidden from view in many cultures. Much has been done to change this and progress is constantly being made, in fact, October 9, 2011 was Mental Health Day.

The DSM-IV is a book full of codes that describe ‘disorders’, some of which appear to pathological descriptions of perfectly normal behavior. Today I learned that the DSM-V will likely remove the bereavement period following a death and immediately classify depression after a death as a diagnosable condition in order to begin treatment as quickly as possible. I found this to be startling and absurd. In fact, it was the tipping point for this rant.

Why is it not okay to be sad after a significant life altering event? Why are we required to fit a standardized description of how to grieve, how often to cry, when to show emotion, when to be angry? Don’t misunderstand me, there are certainly extreme behaviors that do need to be diagnosed and treated medically, but why does the human condition need to be treated?

I have had personal experiences with mental illness, and I understand the importance of Physicians having a method to share language and to communicate treatment universally, and in this way the DSM-IV is in valuable. However, I disagree that the number of diagnoses found within the DSM-IV are actual conditions, and I whole heartedly believe that there conditions that do not require “coding”. If we look at a person’s mental health status and we assess their affect before a life changing event and after, and we assess them with this ‘big picture’ perspective, I think we would find that not all “conditions” need to be diagnosed. In fact, pain and sadness are normal parts of life that are not pathological and need to occur in order to make us stronger.

Sadly it seems that the underlying reason to diagnose all conditions is in order to create pharmaceutical interventions.

I’ll leave you with one of my favorite quotes:

“We have built great pharmaceutical empires bent on masking, subduing, and eradicating pain, even emotional pain, from our lives. We are taught to view pain as an enemy, not a teacher. But pain is the right hand of growth and transformation. Pain is in the history of all human wisdom.”
– Ani DiFranco

Mind Games, University of Toronto


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